Many veterans focus their VA disability claims on the injuries or illnesses that began during their military service. However, one of the most overlooked but powerful ways to increase a VA disability rating is by claiming secondary conditions. A secondary condition is a new disability that was caused or aggravated by an already service-connected condition. The VA recognizes that disabilities can have a domino effect, leading to other health problems over time.
Understanding and properly claiming secondary conditions is crucial for receiving a disability rating that accurately reflects the full impact of your service-connected disabilities on your life. This guide will explain what secondary conditions are, provide common examples, and outline the steps required to prove them to the VA, illustrating why they are a critical component of any comprehensive disability claim strategy.
What Are Secondary Conditions?
A secondary condition is any health problem that would not have occurred (or would not be as severe) if not for your primary service-connected disability. The VA acknowledges that the human body is an interconnected system. An injury to one part can cause strain on another, and the chronic stress of one condition can lead to the development of a completely different one.
For the VA to grant service connection on a secondary basis, you must be able to prove a medical link between your new condition and your existing service-connected disability. This connection is not always obvious, which is why medical evidence is key.
Common Examples of Secondary Conditions
The possibilities for secondary conditions are nearly endless, but some patterns are very common among veterans. Recognizing these connections can help you identify potential secondary claims you may have overlooked.
Here are some common examples:
- Radiculopathy Secondary to a Back Injury: A service-connected back condition like degenerative disc disease can cause pinched nerves, leading to pain, numbness, or tingling that radiates down your legs (sciatica) or into your arms.
- Depression Secondary to Chronic Pain: Living with constant pain from a service-connected orthopaedic condition can take a significant toll on your mental health, often leading to clinical depression or anxiety.
- Sleep Apnea Secondary to PTSD: The hypervigilance and stress associated with PTSD have been medically linked to an increased risk of developing obstructive sleep apnea.
- Migraines Secondary to Tinnitus or a Neck Injury: The constant ringing from service-connected tinnitus can be a trigger for debilitating migraines. Similarly, a neck injury can lead to cervicogenic headaches.
- GERD Secondary to Pain Medications: If you take NSAIDs (like ibuprofen) regularly to manage a service-connected condition like arthritis, the long-term use of these medications can cause gastroesophageal reflux disease (GERD).
- Erectile Dysfunction (ED) Secondary to PTSD or Medication: Both the psychological effects of PTSD and the side effects of many antidepressants can lead to erectile dysfunction.
- Hypertension Secondary to Chronic Pain or PTSD: The body’s stress response to chronic pain or mental health conditions can contribute to high blood pressure over time.
- An Orthopaedic Condition Secondary to Another: A service-connected right knee injury may cause you to change your gait, putting more pressure on your left knee or hip. Over time, this can cause arthritis in the “good” limb, making it a secondary condition.
How to Prove a Secondary Condition
Proving a secondary claim requires the same level of evidence as a primary claim, but the focus is on establishing the link between your two conditions.
You must provide the VA with three key pieces of evidence:
- A Current Diagnosis of the Secondary Condition: You must have a current diagnosis from a qualified medical professional for the new condition you are claiming. For example, if you are claiming depression secondary to back pain, you need an official diagnosis of depression from a doctor or mental health provider.
- An Already Service-Connected Primary Condition: You must already be service-connected for the disability that you believe caused the secondary condition. The VA needs to see that the root cause is officially tied to your military service.
- A Medical Nexus Letter Linking the Two: This is the most critical element. You need a medical opinion from a qualified provider that explicitly connects your secondary condition to your primary service-connected disability.
The nexus letter for a secondary claim should state something like: “It is at least as likely as not that the veteran’s [secondary condition] was caused or aggravated by their service-connected [primary condition].” The doctor should also provide a medical rationale explaining the physiological or psychological pathway that connects the two conditions. For instance, they might explain how chronic pain signals can alter brain chemistry, leading to depression.
Why Secondary Claims Are So Powerful
Filing for secondary conditions is not just about adding another disability to your list; it is a powerful strategy for ensuring your overall rating is accurate and fair.
Here’s why secondary claims are so important:
- They Can Significantly Increase Your Total Rating: Each service-connected condition, whether primary or secondary, contributes to your combined disability rating. Adding one or more secondary conditions can be the key to reaching a higher rating threshold, such as 50%, 70%, or even 100%.
- They Recognize the Full Impact of Your Disabilities: Your service-connected injuries don’t exist in a vacuum. Secondary claims acknowledge the cascading effect that a disability can have on your overall health and quality of life.
- They Can Provide a Clearer Path to 100%: In some cases, it can be easier to reach a 100% rating by combining multiple conditions, including secondaries, than by trying to get a 100% rating for a single disability.
Don’t Overlook What You’ve Earned
Never overlook the potential for secondary claims. Take a holistic look at your health and consider whether any of your non-service-connected conditions could have been caused or worsened by the disabilities you already have connected to your service.
Discussing these connections with your doctor and securing a nexus letter is the definitive way to prove your case to the VA. By recognizing and claiming secondary conditions, you are ensuring that you receive the full benefits you are entitled to for the total impact of your military service on your health.
Helping The Brave is here to help you identify potential secondary claims and build the strong evidence needed to win them.